Testicular cancer is a rare but serious cancer affecting the testicles. While highly treatable, early detection is crucial for better outcomes.
What is testicular cancer?
Testicular cancer develops from cells within the testicles. The most common type is germ cell cancer, which is divided into seminomas and non-seminomas. Seminomas tend to grow slower and are more responsive to treatment, while non-seminomas are often more aggressive but still highly treatable. The exact cause isn't fully understood, but risk factors include undescended testicles (cryptorchidism), family history of testicular cancer, and certain genetic conditions. Testicular cancer is relatively rare and is most commonly diagnosed for those assigned male at birth between the ages of 15 – 35. There is a 95% five-year survival rate for those who have localized testicular cancer.
Regular self-exams are crucial for early detection. Signs and symptoms to look for include:
- A dull ache, pain, or discomfort in the testicle, scrotum, or groin
- A feeling of heaviness in the scrotum
- Painless swelling of the scrotum
- Sudden enlargement of a testicle
- The presence of a firm or hard mass in the testicle
Learn more about how to check yourself for testicular cancer with regular self-exams.
AHN Urologic Oncology Center of Excellence
Our testicular cancer experts at the AHN Urologic Oncology Center of Excellence focus exclusively on urological cancers. This intensive approach gives us the expertise to quickly and precisely diagnose and treat testicular cancer. Our approach to care includes robust support services to help you feel your best during treatment.
The comprehensive cancer center is designed to maximize your convenience and care. Shortly after diagnosis, you will meet with several specialists, like a urologist and medical oncologist. We reduce your travel and wait time so you can get answers as quickly as possible.
Testicular cancer care at AHN: Why choose us?
Specialists at the Cancer Institute use the latest techniques and technology to provide a comprehensive treatment plan. Our treatment approach includes:
- Team approach: We work closely with urologists, oncologists, and other specialists to quickly and comprehensively treat testicular cancer.
- Collaboration: You see the specialists you need in one place, at one time. This approach ensures the quickest possible diagnosis. You also have access to our robust support services, such as support groups and palliative care.
- Expert care: Our testicular cancer specialists use the latest protocols so you receive the most precise diagnosis. A specific diagnosis helps us create an effective treatment plan, tailored to your needs.
Testicular cancer symptoms and signs
A lump or enlargement in either testicle is the most common symptom. The lump may be painless or may cause discomfort or a feeling of heaviness. Testicular cancer lumps are typically hard and feel like a small, firm pebble within the testicle. However, it's crucial to understand that not all lumps are cancerous, and not all testicular cancer lumps will feel exactly the same. Any noticeable change in the size, shape, or texture of your testicles warrants a visit to a doctor for a professional evaluation. Common signs and symptoms of testicular cancer include:
- A feeling of heaviness in the scrotum: The scrotum might feel full or heavy, even without a noticeable lump.
- Pain or discomfort in a testicle or the scrotum: This pain can be sharp or dull, constant or intermittent.
- Enlargement or tenderness of the breasts: Some types of testicular cancer can produce hormones that cause breast enlargement or tenderness.
- A dull ache in the lower abdomen or groin: This pain might feel like a pulled muscle or general discomfort.
- Sudden collection of fluid in the scrotum: This can cause swelling and discomfort.
- Back pain: Back pain can be a sign of more advanced testicular cancer that has spread to the lymph nodes in the back of the abdomen.
Causes and risk factors
Testicular cancer, while relatively rare, affects a younger age group of those assigned male at birth, usually between the ages of 15 – 35. We don't know exactly what causes it, but having undescended testicles (cryptorchidism) at birth significantly increases the risk. Another cause or risk factor is a family history of testicular cancer. Certain genetic conditions can play a role, and some research suggests a link to ethnicity. Ultimately, while some risk factors are identifiable, the exact cause of most cases remains unknown.
The causes and risk factors for developing testicular cancer vary from person to person. Your AHN urologist will be able to discuss with you, in depth, about your overall health and health history to determine what your personal risk factors may be.
Testicular cancer screening and diagnosis
Diagnosing testicular cancer involves several steps to confirm the presence and type of cancer. This begins with a physical exam, where the doctor checks for lumps or abnormalities in the testicles. From there, your AHN urologist may use other tests and screening that could include:
- Imaging tests: This includes an ultrasound to better visualize the testicle and any suspicious areas and a CT scan to look for evidence of spreading.
- Blood tests: Blood tests will help provide information to measure tumor markers like alpha-fetoprotein (AFP) and beta-human chorionic gonadotropin (β-hCG). They may be used to assess the extent of the cancer.
Types and stages of testicular cancer
Testicular cancer is primarily categorized into two main types based on the cells from which they originate and how fast or slow they develop.
Germ cell tumors
Germ cell tumors originate in the germ cells found in the sperm-producing tissue of the testicle. These are the most common types of testicular cancer and are further divided into:
- Seminomas: These are typically slower-growing and more responsive to treatment.
- Non-seminomas: This category encompasses several subtypes, including embryonal carcinomas, yolk sac tumors, choriocarcinomas, and teratomas. Non-seminomas can also contain multiple cell types within a single tumor. The type of cancer, which is determined after removal of the testicle, guides future therapies.
Stages of testicular cancer
The stage of testicular cancer describes how far the cancer has spread:
- Stage I: Cancer is confined to the testicle.
- Stage II: Cancer has spread to the lymph nodes in the retroperitoneum (behind the abdomen).
- Stage III: Cancer has spread to distant parts of the body, such as the lungs, liver, or brain.
Within these stages, there can be further sub-categorizations based on the size and characteristics of the tumor and the extent of lymph node involvement. Accurate staging is crucial for determining the best course of treatment.
Testicular cancer treatment
Treatment for testicular cancer depends on several factors, including the type and stage of cancer, as well as the patient's overall health. Here are some common treatment options:
- Surgery: This is the first line of treatment for testicular cancer. The most common surgery is a radical inguinal orchiectomy, where the affected testicle is surgically removed. Depending on the stage, lymph nodes in the abdomen may also be removed.
- Chemotherapy: This involves using drugs to kill cancer cells. It may be recommended after surgery to destroy any remaining cancer cells in the body, especially for more advanced stages.
- Radiation therapy: This uses high-energy rays to kill cancer cells and is sometimes used after surgery, often for seminomas, a specific type of testicular cancer.
Reproductive health and fertility after treatment
Testicular cancer and its treatments, such as surgery, chemotherapy, and radiation, can potentially affect reproductive health in several ways. It's important to discuss these possibilities with your doctor or a fertility specialist before starting treatment. They can provide personalized information, discuss fertility preservation options, and address any concerns you may have.
Reproductive health can be affected including:
- Sperm production: Treatment can disrupt sperm production, sometimes temporarily and sometimes permanently. This can make it difficult or impossible to father a child in the future.
- Hormone levels: The testicles produce testosterone, which is important for sex drive, muscle mass, and other aspects of men's health. Treatment can affect testosterone levels, leading to side effects. Hormone replacement therapy may be an option to manage these changes.
Options to preserve fertility include:
- Sperm banking: Freezing sperm before treatment is a common and effective way to preserve the possibility of having biological children later.
- Testicular tissue freezing: This is a newer and less established option, but it may be a possibility for some patients.
- Gonadal shielding: During radiation therapy, special shields can sometimes be used to protect the remaining testicle from radiation exposure, potentially preserving its function. However, the feasibility and effectiveness of this approach depend on the specific location and extent of the tumor.
It's important to remember that not everyone experiences infertility after testicular cancer treatment. Many factors can influence fertility, including the type and stage of cancer, the specific treatments used, and the individual's overall health.
Testicular cancer FAQs
It’s common to have questions when facing a testicular cancer diagnosis. AHN is here to help. Your AHN Care Team is available to answer your questions and help you understand your diagnosis. If you need help wrapping your head around a potential testicular cancer diagnosis, these FAQs can help answer some questions.
What are five warning signs of testicular cancer?
It's important to note that not all those with testicular cancer will experience these symptoms, and some may experience only one or a combination of these signs. Any changes in your testicles warrant a visit to a doctor for evaluation. The five warning signs of testicular cancer include:
- A lump or swelling in either testicle: This is the most common sign.
- A feeling of heaviness in the scrotum: The affected testicle might feel heavier than the other.
- Pain or discomfort in a testicle or in the scrotum: While not always present, pain can be a symptom.
- A sudden enlargement of a testicle: A noticeable increase in size of one testicle compared to the other.
- A dull ache in the lower abdomen or groin: This pain can be intermittent or persistent.
Will I still be able to have children after treatment? What options are available to preserve my fertility?
The ability to have children after testicular cancer treatment depends on several factors, including the type of cancer, the stage at diagnosis, and the specific treatment received. Some treatments, particularly surgery to remove the affected testicle, can directly impact fertility. However, options exist to preserve fertility before, during, or after treatment. Those options may include sperm banking and testicular sperm extraction with cryopreservation.
How will treatment affect my sex life?
Testicular cancer and its treatment can significantly impact intimacy, both physically and emotionally. Surgery, radiation, and chemotherapy may cause physical changes like decreased libido, erectile dysfunction, or pain, affecting sexual function and confidence. Emotional distress from diagnosis and treatment can also lead to anxiety, depression, and relationship difficulties. Open communication your AHN providers and partners, along with support groups, is crucial for managing these challenges. Ultimately, a fulfilling intimate life after treatment is possible with appropriate support and management.
How can I check for testicular cancer?
To check for testicular cancer, perform a self-exam regularly, ideally monthly, after a warm shower or bath when the scrotum is relaxed. Gently roll each testicle between your thumb and fingers, feeling for any lumps, bumps, or changes in size, shape, or consistency. A normal testicle feels smooth and firm, about the size of a walnut. If you notice anything unusual, such as a hard lump, swelling, or change in texture, consult a doctor immediately. Early detection is crucial for successful treatment.
How curable is testicular cancer?
Testicular cancer is highly curable, especially when detected and treated early. The cure rate is very high, exceeding 95% for localized disease (cancer confined to the testicle). Even when the cancer has spread, treatment options are available, and most patients achieve long-term remission or a cure. The specific prognosis depends on several factors, including the type of cancer, stage at diagnosis, and the individual's response to treatment. However, the overall outlook for testicular cancer is exceptionally positive.
Contact us
Call (412) DOCTORS (412) 362-8677 or request an appointment to learn more about testicular cancer screening.
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